Preceptor: Libia Moy, M.D.
Course Code:  13-21
Telephone: (212) 263-5407

Prerequisites: Pediatric Clerkship

Description

Students are exposed to the entire range of congenital and acquired digestive disease in infants, children and young adults. The main objective of the elective rotation is to provide the student with a basic understanding of pathophysiology, diagnosis and management of common forms of GI disease in children. Students will participate in daily teaching rounds, attend pediatric GI outpatient clinics, observe procedures such as diagnostic endoscopy, pH monitoring, and hydrogen breath tests.

Objectives of the Elective

This elective shall serve to:

1. Develop a basic understanding of normal gastrointestinal development and correlation of GI disorders with the underlying pathophysiology;  
2. Approach to pediatric gastrointestinal history and examination, including appropriate diagnostic evaluation of children with jaundice, diarrhea, constipation, feeding difficulties and chronic functional disorders;
3. Have an understanding of the most common liver disorders, including the differential diagnosis of direct and indirect hyperbilirubinemia, biliary atresia, chronic active-autoimmune-hepatitis, drug-induced hepatitis, congenital cholestatic syndromes, end-stage liver disease and liver failure, indications for liver transplantation; 
4. Have an understanding of inflammatory bowel disease (Crohn’s Disease and Ulcerative Colitis), the presentation and clinical course, therapeutic options, drugs, biologic agents, indications for surgery;
5. Understand the pathophysiology and lthe basic principles of treatment of the short bowel syndrome and othermalabsorption states;
6. Understand the range of radiological diagnostic modalities, including ultrasound, CT scanning, MRI, MRCP, nuclear medicine scans for Meckel’s diverticular bleed, liquid and solid gastric emptying tests, salivagram for aspiration, and ERCP;  
7. Common surgical procedures for congenital GI disorders, including T-E fistula and esophageal atresia,omphalocele and gastroschisis, short bowel syndrome with dilated loops, anorectal malformations,Hirschprung’s disease and the basic principles of pre-and post-operative care.

Key Responsibilities of the student while on Elective

1. Work up all new patients and consults in conjunction with the Pediatric GI attending. The resident/student must keep abreast with changes in the patient's condition and know current laboratory, and x-ray findings. This will expedite discussion and the educational experience when the patient is presented to the attending.
2. Assist the attending in writing notes i.e.; admit, consult, operative and daily progress. Uncomplicated consults may not require follow up notes. Highlight our management plan with reasons for it, and our "expert" recommendations. These should be clearly communicated to the Pediatric Housestaff to ensure a global teamwork approach to the management of the patient. 
3. Pediatric GI clinic - see under scheduled activities. To maximize the clinical; learning experience, the clinic takes precedence over other clinical activities unless prior arrangements are made with the Pediatric GI attending. 
4. Prepare short summaries of relevant clinical and basic science questions raised during the evaluation and management of patients, making using of Internet resources and exercising critical judgment during the search and presentation.
5. Participate actively during the clinical encounters, both in the office and in clinic, eliciting and amplifying pertinent aspects of the history, and developing a first hand rapport with the patients and parents.  

These are daily one hour sessions, held on an informal basis, with the GI attending or nurse practitioner. They are designed to encompass the pre-set educational objectives and any patient related issues. Residents/students will be assigned related topics, at regular intervals, and expected to present to the group.

Method of Evaluation

The GI attending of the month is the students Faculty preceptor. Evaluation is performed by the attending in conjunction with the GI nurse practitioner.

Scheduling Information

Months Offered: All Year except Jul & Aug

Report To: 160 East 32nd Street, Second Floor at pre-set times after discussion with GI attending.

Students Per Period: 2

Duration: 2 - 4 Weeks